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Frequency and profile of objective cognitive deficits in hospitalized patients recovering from COVID-19
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Abstract
Early reports and case series suggest cognitive deficits occurs in some patients with COVID-19. We evaluated the frequency, severity, and profile of cognitive dysfunction in patients recovering from prolonged COVID-19 hospitalization who required acute inpatient rehabilitation prior to discharge. We analyzed cross-sectional scores from the Brief Memory and Executive Test (BMET) in a cohort of N = 57 COVID-19 patients undergoing inpatient rehabilitation, calculating the frequency of impairment based on neuropsychologist diagnosis and by age-normed BMET subtests. In total, 43 patients (75%) were male, 35 (61%) were non-white, and mean age was 64.5 (SD = 13.9) years. In total, 48 (84%) were previously living at home independently. Two patients had documented preexisting cognitive dysfunction; none had known dementia. Patients were evaluated at a mean of 43.2 (SD = 19.2) days after initial admission. In total, 50 patients (88%) had documented hypoxemic respiratory failure and 44 (77%) required intubation. Forty-six patients (81%) had cognitive impairment, ranging from mild to severe. Deficits were common in working memory (26/47 [55%] of patients), set-shifting (21/44 [47%]), divided attention (18/39 [46%]), and processing speed (14/35 [40%]). Executive dysfunction was not significantly associated with intubation length or the time from extubation to assessment, psychiatric diagnosis, or preexisting cardiovascular/metabolic disease. Attention and executive functions are frequently impaired in COVID-19 patients who require acute rehabilitation prior to discharge. Though interpretation is limited by lack of a comparator group, these results provide an early benchmark for identifying and characterizing cognitive difficulties after COVID-19. Given the frequency and pattern of impairment, easy-to-disseminate interventions that target attention and executive dysfunctions may be beneficial to this population.
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“A recent article showed changes in working memory, set-shifting, divided attention, and processing speed in a cohort of 57 patients recovering from moderate/severe patients with COVID-19”
From Cognitive decline following acute viral infections: literature review and projections for post-COVID-19 (2022) · cites this paper as [142]
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“not being associated with intubation length, psychiatric and clinical diagnosis [142].”
From Cognitive decline following acute viral infections: literature review and projections for post-COVID-19 (2022) · cites this paper as [142]
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COVID-19 induces CNS cytokine expression and loss of hippocampal neurogenesis
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“present with difficulty concentrating, insomnia, fatigue, hallucinations, delusions and behavioural changes, including suicide.(1,2)”
BackgroundResultInfluentialCOVID-19 associated cognitive impairment: A systematic review
Tavares-Júnior, J. W. L., de Souza, A. C. C., Borges, J. W. P., Oliveira, D. N., Neto, J. I. S., Sobreira-Neto, M. A., & Braga‐Neto, P. (2022) · Cortex · doi:10.1016/j.cortex.2022.04.006 · Cited by 179
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“This profile is similar to previous reports on post-acute status of hospitalized COVID19 patients and congruent with known cognitive outcomes of patients following critical illness and ARDS.(7,9,42,43) However, a very recent study found impairments in executive functioning, processing speed, category fluency, memory e…”
ResultInfluentialRapid vigilance and episodic memory decrements in COVID-19 survivors
Zhao, S., Shibata, K., Hellyer, P. J., Trender, W. R., Manohar, S., Hampshire, A., & Husain, M. (2021) · Brain Communications · doi:10.1093/braincomms/fcab295 · Cited by 127
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Post-acute sequelae of COVID-19: Evidence of mood & cognitive impairment
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Neurocognitive Profiles in Patients With Persisting Cognitive Symptoms Associated With COVID-19
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“Jaywant et al. (2021) used the Brief Memory and Executive Test to examine cognitive function in 57 medically stable inpatients recovering from COVID-19.”
BackgroundMethodResultCognitive impairment in people with previous COVID-19 infection: A scoping review
Bertuccelli, M., Ciringione, L., Rubega, M., Bisiacchi, P. S., Masiero, S., & Felice, A. D. (2022) · Cortex · doi:10.1016/j.cortex.2022.06.002 · Cited by 110
“Non-ICU-admitted subjects were assessed in a higher proportion of studies (11/19), showing cognitive impairment in 7 studies (Alemanno et al., 2021; Bonizzato et al., 2022; Heyns et al., 2021; Hosp et al., 2021; Jaywant et al., 2021; Miskowiak et al., 2021; Pirker-Kees et al., 2021).”
InfluentialDamiano, R. F., Guedes, B. F., de Rocca, C. C., de Pádua Serafim, A., Castro, L. H. M., Munhoz, C. D., Nitrini, R., Filho, G. B., Miguel, E. C., Lucchetti, G., et al. (2022) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-021-01286-4 · Cited by 98
“A recent article showed changes in working memory, set-shifting, divided attention, and processing speed in a cohort of 57 patients recovering from moderate/severe patients with COVID-19, not being associated with intubation length, psychiatric and clinical diagnosis [142].”
BackgroundCOVID-19 induces neuroinflammation and loss of hippocampal neurogenesisPreprint
Klein, R., Soung, A., Sissoko, C. A., Nordvig, A., Canoll, P., Mariani, M. B., Jiang, X.-P., Bricker, T., Goldman, J., Rosoklija, G., et al. (2021) · Research Square · doi:10.21203/rs.3.rs-1031824/v1 · Cited by 65
Damiano, R. F., Caruso, M. J. G., Cincoto, A. V., Rocca, C. C. D. A., Serafim, A. D. P., Bacchi, P. S., Guedes, B. F., Brunoni, A. R., Pan, P. M., Nitríni, R., et al. (2021) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2022.01.002 · Cited by 101
Cognitive Dysfunction, Psychiatric Distress, and Functional Decline After COVID-19
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“More recently, 81% of patients (n = 57, mean age 65 years) recovering from COVID-19 infection on an inpatient rehabilitation unit showed mild to severe cognitive impairment on a battery assessing memory and executive functioning, with deficits occurring most frequently in working memory, set shifting, divided, attenti…”
Dementia and COVID-19, a Bidirectional Liaison: Risk Factors, Biomarkers, and Optimal Health Care
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Whiteside, D. M., Basso, M. R., Naini, S. M., Porter, J. N., Holker, E. G., Waldron, E. J., Melnik, T. E., Niskanen, N., & Taylor, S. E. (2022) · The Clinical Neuropsychologist · doi:10.1080/13854046.2022.2030412 · Cited by 86
“The existing literature on cognitive dysfunction following COVID-19 has mostly focused on relatively short-term outcomes (e.g., Almeria et al., 2020; Jaywant et al., 2021; Whiteside et al., 2021; Zhou et al., 2020); thus, this is one of the first studies to examine longer-term outcomes in both…”
BackgroundCognitive Impairment in Non-critical, Mild-to-Moderate COVID-19 Survivors
Henneghan, A. M., Lewis, K., Gill, E. R., & Kesler, S. R. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.770459 · Cited by 87
Miskowiak, K. W., Pedersen, J. K., Gunnarsson, D. V., Roikjer, T. K., Podlekareva, D. N., Hansen, H., Dall, C. H., & Johnsen, S. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.12.122 · Cited by 79
“2022), other studies found high frequencies of impairment across executive function, attention and memory (Bungenberg et al. 2022; CostasCarrera et al. 2022; Crivelli et al. 2022; Jaywant et al. 2021; Krishnan et al. 2022; Lopez-Leon et al. 2021; Mazza et al. 2021; Miskowiak et al. 2021; Miskowiak et al. 2022).”
Tetrahydroxy stilbene glycoside ameliorates neuroinflammation for Alzheimer's disease via cGAS-STING
Gao, D., Hao, J.-P., Li, B., Zheng, C.-C., Miao, B.-B., Zhang, L., Li, Y., Li, L., Li, X., & Zhang, L. (2023) · European Journal of Pharmacology · doi:10.1016/j.ejphar.2023.175809 · Cited by 82
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SARS-CoV-2 and the Brain: What Do We Know about the Causality of ‘Cognitive COVID?
Awan, H. A., Diwan, M. N., Aamir, A., Ali, M., Giannantonio, M. D., Ullah, I., Shoib, S., & Berardis, D. D. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10153441 · Cited by 71
Voruz, P., Cionca, A., de Alcântara, I. J., Nuber‐Champier, A., Allali, G., Benzakour, L., Thomasson, M., Lalive, P. H., Lövblad, K., Braillard, O., et al. (2022) · Brain Communications · doi:10.1093/braincomms/fcac057 · Cited by 77
Long COVID Neuropsychological Deficits after Severe, Moderate, or Mild Infection
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“Fourth, to our knowledge, only two studies have so far explored the short-term impact (10 40 days post-hospital discharge) of SARS-CoV-2 infection on cognition by using a validated and standardized methodology with face-to-face interviews [21,22].”
Postacute/Long COVID in Pediatrics
Morrow, A. K., Ng, R., Vargas, G., Jashar, D. T., Henning, E., Stinson, N., & Malone, L. A. (2021) · American Journal of Physical Medicine & Rehabilitation · doi:10.1097/phm.0000000000001896 · Cited by 68
“On neuropsychological testing, patients are demonstrating impaired performance primarily with attention as opposed to other domains, such as executive functioning or working memory, which has been reported in the adult literature.(39,47) Elevated anxiety and depression symptoms are also commonly reported.”
BackgroundNeurocognitive deficits in severe COVID-19 infection: Case series and proposed model
Whiteside, D. M., Oleynick, V. C., Holker, E. G., Waldron, E. J., Porter, J. N., & Kasprzak, M. (2021) · The Clinical Neuropsychologist · doi:10.1080/13854046.2021.1874056 · Cited by 71
“Similarly, another paper on medRxiv by Jaywant et al. (2020) used the Brief Memory and Executive Test (BMET) and identified attention and executive functions as the most commonly affected cognitive domains among medically-stable inpatients recovering from COVID-19.”
MethodResultCOVID-19 causes neuronal degeneration and reduces neurogenesis in human hippocampus
Bayat, A., Azimi, H., Moghaddam, M. H., Ebrahimi, V., Fathi, M., Vakili, K. G., Mahmoudiasl, G., Forouzesh, M., Boroujeni, M. E., Nariman, Z., et al. (2022) · APOPTOSIS · doi:10.1007/s10495-022-01754-9 · Cited by 67
Voruz, P., Cionca, A., de Alcântara, I. J., Nuber‐Champier, A., Allali, G., Benzakour, L., Lalive, P. H., Lövblad, K., Braillard, O., Nehme, M., et al. (2022) · Human Brain Mapping · doi:10.1002/hbm.26163 · Cited by 63
“…et al., 2021; Raman et al., 2021; Solaro et al., 2021; Udina et al., 2021), memory functions (Almeria et al., 2020; Hampshire et al., 2021; Jaywant et al., 2021; Whiteside et al., 2021; Woo et al., 2020), attention (Alemanno et al., 2021; Almeria et al., 2020; Hampshire et al., 2021),…”
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Cognitive Symptoms of Post–COVID-19 Condition and Daily Functioning
Jaywant, A., Gunning, F. M., Oberlin, L. E., Santillana, M., Ognyanova, K., Druckman, J. N., Baum, M., Lazer, D. M. J., & Perlis, R. H. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2023.56098 · Cited by 60
Self-citationCognitive domains affected post‐COVID ‐19; a systematic review and meta‐analysis
Fanshawe, J. B., Sargent, B., Badenoch, J., Saini, A., Watson, C. J., Pokrovskaya, A., Aniwattanapong, D., Conti, I., Nye, C., Burchill, E., et al. (2024) · European Journal of Neurology · doi:10.1111/ene.16181 · Cited by 56
Cognitive Impairment after Post-Acute COVID-19 Infection: A Systematic Review of the Literature
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“Another cognitive domain severely affected following SARS-CoV-2 infection was the speed of processing that were impaired in 9 studies [46,54,63,65,76,81,83,91,100] out of 26.”
Albu, S., Zozaya, N. R., Murillo, N., García‐Molina, A., Chacón, C. A. F., & Kumru, H. (2021) · Disability and Rehabilitation · doi:10.1080/09638288.2021.1977398 · Cited by 47
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Long-term cognitive impairments following COVID-19: a possible impact of hypoxia
Dondaine, T., Ruthmann, F., Vuotto, F., Carton, L., Gelé, P., Faure, K., Deplanque, D., & Bordet, R. (2022) · Journal of Neurology · doi:10.1007/s00415-022-11077-z · Cited by 43
“[13] showed that 81% of patients with a severe form of COVID-19 (77% had been intubated for a mean duration of 13 days) had a cognitive impairment, although the latter might have resulted from the care received in the intensive care unit (ICU) [14, 15].”
BackgroundKlinkhammer, S., Horn, J., Duits, A., Visser‐Meily, J. M. A., Verwijk, E., Slooter, A. J. C., Postma, A. A., Heugten, C. M. V., & NeNeSCo Study Group (2023) · European Journal of Neurology · doi:10.1111/ene.15812 · Cited by 39
“Preselection of patients with cognitive complaints or neurological symptoms, as employed by some studies, could have also led to a higher prevalence of dysfunction [36].”
BackgroundCognitive Assessment in SARS-CoV-2 Patients: A Systematic Review
Biagianti, B., Di Liberto, A., Nicolò Edoardo, A., Lisi, I., Nobilia, L., de Ferrabonc, G. D., Zanier, E. R., Stocchetti, N., & Brambilla, P. (2022) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2022.909661 · Cited by 41
Vascular Dysfunctions Contribute to the Long-Term Cognitive Deficits Following COVID-19
Shabani, Z., Liu, J., & Su, H. (2023) · Biology · doi:10.3390/biology12081106 · Cited by 41
“In addition, a recent cross-sectional report studied the connection between COVID-19 disease and cognitive signs in 57 hospitalized participants and found a high prevalence of cognitive impairment (>80% of the sample), primarily in the fields of attention and executive function [28].”
BackgroundVoruz, P., de Alcântara, I. J., Nuber‐Champier, A., Cionca, A., Allali, G., Benzakour, L., Lalive, P. H., Lövblad, K.-O., Braillard, O., Nehme, M., et al. (2022) · Archives of Clinical Neuropsychology · doi:10.1093/arclin/acac068 · Cited by 35
“Although research has highlighted a high frequency of neuropsychological deficits in various cognitive functions (Almeria et al., 2020; Jaywant et al., 2021; Krishnan et al., 2022), authors have not envisaged the possibility that this frequency could be comparable with that observed in a normative population (Binder e…”
BackgroundResultMechanisms of coronavirus infectious disease 2019-related neurologic diseases
Klein, R. S. (2022) · Current Opinion in Neurology · doi:10.1097/wco.0000000000001049 · Cited by 35
SARS‐CoV ‐2, aging, and Post‐COVID ‐19 neurodegeneration
Strong, M. J. (2022) · Journal of Neurochemistry · doi:10.1111/jnc.15736 · Cited by 38
“…these neurological deficits which are often present to the same degree as that observed in the acute or subacute phase (Alemanno et al., 2021; Ali et al., 2022; Del Brutto et al., 2021; Graham et al., 2021; Hampshire et al., 2021; Jaywant et al., 2021; Pistarini et al., 2021; Woo et al., 2020).”
BackgroundCOVID-19 and Neurodegenerative Diseases: Prion-Like Spread and Long-Term Consequences
Baazaoui, N., & Iqbal, K. (2022) · Journal of Alzheimer s Disease · doi:10.3233/jad-220105 · Cited by 35
“Indeed, at the time of the discharge, nearly 81% of the survivors of an acute respiratory distress syndrome exhibited cognitive impairment and that after 3 months 40% of them who were critically ill had at least mild cognitive deficits and 26% had moderate cognitive deficits [76].”
BackgroundDisentangling the cognitive, physical, and mental health sequelae of COVID-19
Wild, C. J., Norton, L. E., Menon, D. K., Ripsman, D., Swartz, R. H., & Owen, A. M. (2022) · Cell Reports Medicine · doi:10.1016/j.xcrm.2022.100750 · Cited by 35
“21 17–20,23– 26 Second, how does the emergence of cognitive deficits following COVID-19 infection relate to the severity of the primary”
Can SARS-CoV-2 Infection Lead to Neurodegeneration and Parkinson’s Disease?
Krey, L., Huber, M. K., Höglinger, G. U., & Wegner, F. (2021) · Brain Sciences · doi:10.3390/brainsci11121654 · Cited by 31
The negative impact of COVID-19 on working memory revealed using a rapid online quiz
Baseler, H. A., Aksoy, M., Salawu, A., Green, A., & Asghar, A. U. R. (2022) · PLoS ONE · doi:10.1371/journal.pone.0269353 · Cited by 34
“Using this methodological approach, short-term memory deficits have been reported for COVID-19 in some studies, although these investigations have been limited to small cohorts (6–87 patients) [5,15,16,18,19].”
MethodResultKirchberger, I., Peilstöcker, D., Warm, T. D., Linseisen, J., Hyhlik-Dürr, A., Meisinger, C., & Goßlau, Y. (2023) · Viruses · doi:10.3390/v15010256 · Cited by 31
“[36] found mild to severe cognitive impairment in 81% of 57 COVID-19 patients 7 days after diagnosis.”
BackgroundPatel, N., Steinberg, C., Patel, R., Chomali, C., Doulatani, G., Lindsay, L., & Jaywant, A. (2021) · American Journal of Physical Medicine & Rehabilitation · doi:10.1097/phm.0000000000001897 · Cited by 30
Self-citationCognitive impairment and functional change in COVID-19 patients undergoing inpatient rehabilitation
Patel, R., Savrides, I., Cahalan, C., Doulatani, G., O’Dell, M. W., Toglia, J. P., & Jaywant, A. (2021) · International Journal of Rehabilitation Research · doi:10.1097/mrr.0000000000000483 · Cited by 31
“Seventeen patients were not administered our cognitive measure because (1) they were 59 admitted prior to knowledge of COVID-19-related cognitive deficits and the implementation of 60 our screening protocol; (2) clinicians deemed it could not be reliably administered due to 61 language barriers; or (3) clinicians deem…”
BackgroundSelf-citationThe Effects of Extrinsic and Intrinsic Factors on Neurogenesis
Jiang, M. H., Jang, S. E., & Zeng, L. (2023) · Cells · doi:10.3390/cells12091285 · Cited by 34
Neurological manifestation in COVID-19 disease with neuroimaging studies.
Ghaderi, S., Olfati, M., Ghaderi, M., Hadizadeh, H., Yazdanpanah, G., Khodadadi, Z., Karami, A., Papi, Z., Abdi, N., Jalali, S. S. S., et al. (2023) · PubMed Central · Cited by 28
Citicoline and COVID-19-Related Cognitive and Other Neurologic Complications
Turana, Y., Nathaniel, M., Shen, R., Ali, S., & Aparasu, R. R. (2021) · Brain Sciences · doi:10.3390/brainsci12010059 · Cited by 33
“With regard to COVID-19 severity, 88% of the patients had hypoxemic respiratory failure and 77% required intubation [16].”
BackgroundDementia Clinical Care in Relation to COVID-19
Bianchetti, A., Rozzini, R., Bianchetti, L., Coccia, F., Guerini, F., & Trabucchi, M. (2022) · Current Treatment Options in Neurology · doi:10.1007/s11940-022-00706-7 · Cited by 29
Rehabilitation Strategies for Cognitive and Neuropsychiatric Manifestations of COVID-19
Rolin, S. N., Chakales, A., & Verduzco‐Gutierrez, M. (2022) · Current Physical Medicine and Rehabilitation Reports · doi:10.1007/s40141-022-00352-9 · Cited by 34
Liu, T. C., Yoo, S. M., Sim, M., Motwani, Y., Viswanathan, N., & Wenger, N. S. (2023) · JAMA Network Open · doi:10.1001/jamanetworkopen.2023.11974 · Cited by 30
Brown, L. A., Ballentine, E., Zhu, Y., McGinley, E. L., Pezzin, L. E., & Abramoff, B. A. (2022) · Brain Behavior & Immunity - Health · doi:10.1016/j.bbih.2022.100460 · Cited by 33
Zhao, J., Xia, F., Jiao, X., & Lyu, X. (2024) · Frontiers in Neurology · doi:10.3389/fneur.2024.1367974 · Cited by 31
Palladini, M., Bravi, B., Colombo, F., Caselani, E., Pasquasio, C. D., D'Orsi, G., Rovere, P. Q., Poletti, S., Benedetti, F., & Mazza, M. G. (2022) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2022.2075016 · Cited by 32
“…the specific cognitive domains, previous studies found that executive function and verbal fluency were among the most affected cognitive domains (Almeria et al., 2020; Beaud et al., 2021; Hampshire et al. 2020; Helms et al., 2020; Jaywant et al., 2021) both in acute and sub-acute stages.”
BackgroundResultInfluentialLlana, T., Méndez, M., Zorzo, C., Fidalgo, C., Juan, M. ‐., & Méndez-López, M. (2022) · Frontiers in Neuroscience · doi:10.3389/fnins.2022.1082811 · Cited by 32
“, 2021), memory is the predominant function altered, but also executive functions and visuospatial function (Ardila and Lahiri, 2020; Beaud et al., 2021; Jaywant et al., 2021; Llana et al., 2022).”
BackgroundWhiteside, D. M., Naini, S. M., Basso, M. R., Waldron, E. J., Holker, E. G., Porter, J. N., Niskanen, N., Melnik, T. E., & Taylor, S. E. (2022) · The Clinical Neuropsychologist · doi:10.1080/13854046.2022.2030411 · Cited by 27
“In addition to finding cognitive deficits in nearly half of patients, 40% of the participants also reported psychiatric symptoms, with 23% having an adjustment disorder, 3% with major depressive disorder (MDD), and 11% with anxiety or mood disorders (Jaywant et al., 2021).”
Backgroundde Erausquin, G. A., Snyder, H. M., Brugha, T. S., Seshadri, S. S., Carrillo, M. C., Sagar, R., Huang, Y., Newton, C. R. J. C., Tartaglia, M. C., Teunissen, C. E., et al. (2022) · Alzheimer s & Dementia Translational Research & Clinical Interventions · doi:10.1002/trc2.12348 · Cited by 27
Omar, A. K. A.-E., Dahesh, S. M. A., Ellakwa, D. E., Gomaa, M. K., Abdulsamad, B., Hanafy, R., Metwally, H. G. A., Mohammad, R. N. E. M., Badawy, S. S., Saleh, R. M. E., et al. (2022) · Middle East Current Psychiatry · doi:10.1186/s43045-022-00245-6 · Cited by 27
Pietro, D. A. D., Comini, L., Gazzi, L., Luisa, A., & Vitacca, M. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18115917 · Cited by 26
“In a series of 57 patients, deficits were common in working memory, set-shifting, divided attention and processing speed, without significant association with intubation length [5].”
BackgroundCastro, V. M., Rosand, J. M., Giacino, J. T., McCoy, T. H., & Perlis, R. H. (2022) · Molecular Psychiatry · doi:10.1038/s41380-022-01646-z · Cited by 22
“For example, a small study suggested that the pattern of neuropsychiatric deficits immediately following hospitalization was non-specific and resembled that observed in individuals without COVID-19 [10].”
ResultInfluentialSelf-citationTavares-Júnior, J. W. L., Oliveira, D. N., da Silva, J. B. S., Feitosa, W. L. Q., Sousa, A. V. M., Cunha, L. C. V., Gaspar, S. D. B., Gomes, C. M. P., de Oliveira, L. L. B., Moreira-Nunes, C. A., et al. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.947583 · Cited by 29
“The most affected cognitive impairment group domain in ACE-R sub-items was the memory, as found in other studies (56, 57), which is relevant because limbic structures may suffer from inflammation (58).”
ResultMemory alterations after COVID-19 infection: a systematic review
Llana, T., Zorzo, C., Méndez-López, M., & Méndez, M. (2022) · Applied Neuropsychology Adult · doi:10.1080/23279095.2022.2123739 · Cited by 26
“The long-COVID-19 syndrome neuropsychological deficits affect attention, frontal/executive functions, memory, and visuospatial function (Ardila & Lahiri, 2020; Beaud et al., 2021; Jaywant et al., 2021).”
BackgroundClinical features and cognitive sequelae in COVID-19: a retrospective study on N=152 patients
Manera, M. R., Fiabane, E., Pain, D., Aiello, E. N., Radici, A., Ottonello, M., Padovani, M., Wilson, B. A., Fish, J. E., & Pistarini, C. (2021) · Neurological Sciences · doi:10.1007/s10072-021-05744-8 · Cited by 26
“Furthermore, ICU admission being shown to affect global cognition but not specific instrumental domains further supports the notion that COVID-19-related cognitive deficits are likely to reflect a decrease in general cognitive efficiency—which is typical of critical illnesses also affecting the CNS [15].”
BackgroundMarkers of limbic system damage following SARS-CoV-2 infection
Thomasson, M., Voruz, P., Cionca, A., de Alcântara, I. J., Nuber‐Champier, A., Allali, G., Benzakour, L., Lalive, P. H., Lövblad, K., Braillard, O., et al. (2023) · Brain Communications · doi:10.1093/braincomms/fcad177 · Cited by 26
Kausel, L., Figueroa-Vargas, A., Zamorano, F. J., Stecher, X., Aspé-Sánchez, M., Carvajal-Paredes, P., Márquez-Rodríguez, V., Martínez-Molina, M. P., Román, C., Soto-Fernández, P., et al. (2024) · Scientific Reports · doi:10.1038/s41598-024-69772-y · Cited by 24
“Most of the research that has identified manifest cognitive deficits typically involves more severe respiratory cases of COVID-19 33–35 or those who present neurological symptoms during the acute episode.”
BackgroundNeuropsychological Outcomes in Adult Patients and Survivors of COVID-19
May, P. E. (2022) · Pathogens · doi:10.3390/pathogens11040465 · Cited by 24
“[21]), this neuropsychological pattern could be a by-product of the selected test battery.”
BackgroundConsensus Clinical Guidance for Diagnosis and Management of Adult COVID-19 Encephalopathy Patients
Michael, B. D., Walton, D., Westenberg, E., García‐Azorín, D., Singh, B., Tamborska, A., Netravathi, M., Chomba, M., Wood, G. K., Easton, A., et al. (2021) · Journal of Neuropsychiatry · doi:10.1176/appi.neuropsych.22010002 · Cited by 26
Wang, Y., Jiang, C., Wu, Y., Lv, T., Sun, H., Liu, Y., Li, L., & Pan, X. (2022) · IEEE Journal of Biomedical and Health Informatics · doi:10.1109/jbhi.2022.3205167 · Cited by 24
The functional and structural changes in the hippocampus of COVID-19 patients
Nouraeinejad, A. (2023) · Acta Neurologica Belgica · doi:10.1007/s13760-023-02291-1 · Cited by 28
“Studies have extensively illustrated that “long COVID” after discharge from hospital consist of an assortment of neuropsychiatric complaints, such as defective instant verbal memory and learning, deferred verbal memory difficulties, verbal fluency problems, working memory issues, anxiety, depression, and post-traumati…”
BackgroundDuñabeitia, J. A., Mera, F., Baró, O., Jadad-Garcia, T., & Jadad, A. R. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20043100 · Cited by 28
Neurocovid-19: efectos del COVID-19 en el cerebro
Matar-Khalil, S. (2022) · Revista Panamericana de Salud Pública · doi:10.26633/rpsp.2022.108 · Cited by 22
Cognitive function following SARS-CoV-2 infection in a population-representative Canadian sample
Hall, P. A., Meng, G., Hudson, A., Sakib, M. N., Hitchman, S. C., MacKillop, J. M., Bickel, W. K., & Fong, G. T. (2022) · Brain Behavior & Immunity - Health · doi:10.1016/j.bbih.2022.100454 · Cited by 22
“Several studies have reported reliable evidence of cognitive dysfunction among those previously infected with SARS-CoV-2 (Jaywant et al., 2021; Becker et al., 2021; Liu et al., 2021; Almeria et al., 2020; Hampshire et al., 2021).”
Cognitive impairment in post-acute COVID-19 syndrome: a scoping review
Cipolli, G. C., Alonso, V., Yasuda, C. L., de Assumpção, D., Cachioni, M., de Melo, R. C., Hinsliff‐Smith, K., & Yassuda, M. S. (2023) · Arquivos de Neuro-Psiquiatria · doi:10.1055/s-0043-1777115 · Cited by 22
Ali, A. M., Kunugi, H., Abdelmageed, H. A., Mandour, A. S., Ahmed, M. E., Ahmad, S., & Hendawy, A. O. (2021) · Fermentation · doi:10.3390/fermentation7040202 · Cited by 20
“The occurrence of these disorders is higher in older patients [35,36,151,152].”
BackgroundGarcía-Grimshaw, M., Chirino‐Pérez, A., Flores-Silva, F. D., Valdés-Ferrer, S. I., Vargas-Martínez, M. D. L. Á., Jiménez-Ávila, A. I., Chávez-Martínez, O. A., Ramos-Galicia, E. M., Marché-Fernández, O. A., Ramírez-Carrillo, M. F., et al. (2022) · Neurological Sciences · doi:10.1007/s10072-021-05798-8 · Cited by 20
García‐Molina, A., García-Carmona, S., Espiña-Bou, M., Rodríguez-Rajo, P., Sánchez-Carrión, R., & Cantallops, A. E. (2022) · Neurología (English Edition) · doi:10.1016/j.nrleng.2022.06.007 · Cited by 20
Velichkovsky, B. B., Razvaliaeva, A. Y., Khlebnikova, A. A., Manukyan, P. A., Kasatkin, V. N., & Barmin, A. V. (2023) · Behavioural Neurology · doi:10.1155/2023/1094267 · Cited by 24
“earlier systematic analyses [45, 46] and further validate their points by pooling effect sizes from studies with healthy control groups.”
BackgroundAkinetic Mutism and Coronavirus Disease 2019: A Narrative Review
Fusunyan, M. A., Praschan, N. C., Fricchione, G. L., & Beach, S. R. (2021) · Journal of the Academy of Consultation-Liaison Psychiatry · doi:10.1016/j.jaclp.2021.08.009 · Cited by 20
“Mild perfusion abnormalities persisted in these regions through 6-month follow-up, which may reflect a shared substrate between AM and longerlasting executive dysfunction observed in many postCOVID patients.(45)”
BackgroundNeurocognitive deficits in COVID-19 patients five months after discharge from hospital
Thornberg, U. B., Andersson, A., Lindh, M., Hellgren, L., Divanoglou, A., & Levi, R. (2022) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2022.2125020 · Cited by 21
“…other test batteries reporting 18% of patients scoring below a cut-o ff of 2 SD on The Brief Memory and Executive Test (BMET) rapid letter-number matching (Jaywant et al., 2021), and approximately 40% below norms using symbol digits modality test (SDMT) (Ferrucci et al., 2021; Mazza et al., 2021).”
BackgroundMethodResultInfluentialAttention profile of physically recovered COVID-19 inpatients on the day of discharge
Filho, Á. D. C., van Duinkerken, E., Tolentino, J. C., & Schmidt, S. L. (2022) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2022.03.047 · Cited by 19
Newhouse, A. L., Kritzer, M. D., Eryilmaz, H., Praschan, N. C., Camprodon, J. A., Fricchione, G. L., & Chemali, Z. N. (2022) · Journal of the Academy of Consultation-Liaison Psychiatry · doi:10.1016/j.jaclp.2022.08.007 · Cited by 17
“7,8 While a direct causal relationship has not been established, many studies addressing neuropsychological pro fi les of post-Covid infection had consistent results: signi fi cantly lower scores in cognition with the lowest subscores in attention, verbal fl uency, and executive function followed by…”
Long-term cognitive dysfunction after the COVID-19 pandemic: a narrative review
Shariff, S., Uwishema, O., Mizero, J., Thambi, V. D., Nazir, A., Mahmoud, A., Kaushik, I., Khayat, S., Maigoro, A. Y., Awde, S., et al. (2023) · Annals of Medicine and Surgery · doi:10.1097/ms9.0000000000001265 · Cited by 19
“COVID-19 impairs cognitive function by affecting several domains, including problem-solving, attention, working memory, and executive functioning [7,52,]64 – 66 .”
Cognitive Deficits in the Acute Phase of COVID-19: A Review and Meta-Analysis
de Alcântara, I. J., Nuber‐Champier, A., Voruz, P., Cionca, A., Assal, F., & Péron, J. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12030762 · Cited by 17
Ali, A. M., & Kunugi, H. (2021) · Immuno · doi:10.3390/immuno1030013 · Cited by 17
“81% of patients) in patients who were cognitively intact before contracting COVID-19 [6,7].”
BackgroundInfluentialHall, P. A., Ayaz, H., Meng, G., Hudson, A., Sakib, M. N., Quah, A. C. K., Agar, T. K., Lee, J. A., Boudreau, C., & Fong, G. T. (2023) · Brain Behavior & Immunity - Health · doi:10.1016/j.bbih.2023.100595 · Cited by 16
“…studies have shown that symptomatic COVID-19 is associated with poorer performance on cognitive tasks (Becker et al., 2021; Hampshire et al., 2021; Jaywant et al., 2021), more self-reported symptoms of cognitive dysfunction (Hall et al., 2022b), and prospective changes in structural brain…”
Burdick, K. E., & Millett, C. E. (2021) · Neuropsychopharmacology · doi:10.1038/s41386-021-00995-7 · Cited by 16
Klinkhammer, S., Horn, J., Visser‐Meily, J. M. A., Verwijk, E., Duits, A., Slooter, A. J. C., & Heugten, C. M. V. (2021) · BMJ Open · doi:10.1136/bmjopen-2021-054901 · Cited by 15
“11 Furthermore, cognitive dysfunction may be associated with cognitive complaints.”
Acute and long-term neurological disorders in patients with coronavirus infection
Parfenov, V. A., & Kulesh, A. A. (2022) · Neurology neuropsychiatry Psychosomatics · doi:10.14412/2074-2711-2022-3-4-11 · Cited by 14
Long COVID: neurological manifestations - an updated narrative review
Tavares-Júnior, J. W. L., Ciurleo, G. C. V., Moura, A. E. F., Vasconcelos, T. D. M. F., de Andrade, M. H., Feitosa, W. L. Q., Sobreira-Neto, A. A., Portugal, C. G., Morais, L. M., Marinho, S. C., et al. (2024) · Dementia & Neuropsychologia · doi:10.1590/1980-5764-dn-2023-0076 · Cited by 17
“A systematic review selected studies that evaluated the recovery of anosmia in patients after 1, 2, and between 3–6 months after COVID-19, showing hyposmia in 37.4, 36.7, and 36.5% of patients, respectively 60 .”
InfluentialGarcía-Grimshaw, M., Sankowski, R., & Valdés‐Ferrer, S. I. (2022) · Current Opinion in Neurology · doi:10.1097/wco.0000000000001046 · Cited by 15
“In COVID-19, only a handful of studies have addressed this question without finding a direct association [72,93].”
BackgroundKognitive Störungen und Schlafstörungen bei Long-COVID
Schilling, C., Meyer‐Lindenberg, A., & Schweiger, J. I. (2022) · Der Nervenarzt · doi:10.1007/s00115-022-01297-z · Cited by 14
Protective down-regulated states in the human brain: A possible lesson from COVID-19
Schiff, N. D., & Brown, E. N. (2022) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2120221119 · Cited by 14
“All of these forms of cognitive impairment reflect fronto-striatal neuronal dysfunction (69, 70).”
BackgroundRaju, V., Reddy, R., Javan, A. C., Hajihossainlou, B., Weissleder, R., Guiseppi‐Elie, A., Kurabayashi, K., Jones, S. A., & Faghih, R. T. (2025) · Biotechnology Advances · doi:10.1016/j.biotechadv.2025.108592 · Cited by 14
Acute and long‑term psychiatric symptoms associated with COVID‑19 (Review)
Paunescu, R., Micluția, I., Verișezan-Roșu, O., & Crecan-Suciu, B. D. (2022) · Biomedical Reports · doi:10.3892/br.2022.1586 · Cited by 17
Metadata
- Authors
- Jaywant, A., Vanderlind, W. M., Alexopoulos, G. S., Fridman, C. B., Perlis, R. H., & Gunning, F. M.
- Affiliations
- NewYork–Presbyterian Hospital (US)
- Weill Cornell Medicine (US)
- Harvard University (US)
- Corresponding author
- Gunning, Faith M.
- Venue
- Neuropsychopharmacology
- Published
- 2021-02-15
- Volume
- 46
- Issue
- 13
- Pages
- 2235-2240
- ISSN
- 0893-133X (ISSN-L)
- 1740-634X
- PMC
- PMC7884062
- OpenAlex
- W3132403899
- Cited by
- 248
- References
- 45
- Citations by year
- 2026: 12 · 2025: 19 · 2024: 35 · 2023: 64 · 2022: 84 · 2021: 34
- FWCI
- 25.96
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Neuropsychopharmacology (publishedVersion)
- medRxiv (acceptedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Keywords
- COVID-19 pandemic, post-COVID cognitive impairment, cognitive impairment, inpatient rehabilitation, executive dysfunction, attention deficits, working memory, set-shifting, divided attention, processing speed, hypoxemic respiratory failure, intubation, hospitalized patients
- MeSH terms
- COVID-19, SARS-CoV-2, Cognition, Cross-Sectional Studies, Humans, Male, Middle Aged, Neuropsychological Tests, Cognitive Dysfunction
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